Surgical instrument



Dec. 18, 1934. H. P. RUSH SURGICAL INS TRUMENT Filed Dec. 18, 1933 Fwd.

lllllllllll llllllmn Patented Dec. 18, 1934 "Q'UNI'TED STATES PATENT OFFICE i 1,985,108.

SURGICAL'INSTRUMENT Henry- P. Rush, San Angelo, Tex. Application-December 18, 1933, Serial No. 703,003

Claims.

7 This invention relates to surgical instruments,

and more particularly tobone clamps used by physicians and, surgeons in making bone transplants and other similar operations, such as wir- 1 5 ing or plating bones.

In operations heretofore made for bone transplants, a vertical clamp has been used, usually adjusted by. means of a screw. The operating means for this type of clamp extend vertically from the bone a distance of several inches. It is necessary of course usually in such operations for the surgeon to employ fscrews. Due to the fact that the clamps heretofore used have been of the vertical type and extend upward from the bone, it is practically impossible for the surgeon to use 'a brace or similar instrument for driving the screws into place. It is also necessary, when using the vertical clamp, for the surgeon's assistant to hold the upper part of the clamp in order to keep itstationary. 'This causes further interference. It is also frequently necessary to adjust the screw to obtain proper coaptation. This requires a great amount of time and also results in interference with the person performing the operation' An object of my invention is to provide a bone holding instrument, the major portion of which extends in. a horizontal plane from the bone being operated upon.

Another object of my invention is'to provide a bone holding device which can be placed in position'in a much shorter time than those here tofore used.

'Still another object of my invention is to provide a bone holding instrument which will permit the use of a brace or the like for driving the screws into the bone or transplant.

7 A further object of my invention is to provide a bone holding instrument which can be readily disengaged so that the same can be thoroughly cleaned and sterilized.

A still further object of my invention is to provide a bone clamp in which one of the clamping means is movable relative to the other.

Yet-another object is to provide a bone holding instrument which can be quickly inserted into position and then locked by a simple means.

With these and other objects in view, which may be incident to my improvements, the invention consists in the parts and combinations to be hereinafter set forth and claimed, with the understanding that the several necessary elements comprising my invention may be varied in construction, proportions and arrangement, without departing from the spirit and scope of the appended claims.

In order to make my invention more clearly understood; I have shown in the accompanying drawing means for carrying, the same into practical effect withoutlimiting the improvements in (01. les -s46 their useful applications to the particular constructions, which, for the purpose of explanation,

have been made the subject of illustration. In the drawing:

Figure l is a" perspective view of the instrument in operative position; 1

Fig. 2 is a side elevation, partly in section;

Fig. 3 is a top plan view along lines 3-3 in Figure 2, looking in the direction of the arrows; Fig. 4 is a modified form of clamping means shown in Figure 1. I

' ln thedrawing I have shown a surgical instrument having upper and lower handle members 1 and 2, respectively, pivotally connected, as indicated at 3. I prefer that this should be a removable pivot to permit the disengagement of the handle members, and thus 'facilitatethorough cleaning and sterilizing of the instrument. While I have shown a screw as the connecting means, it is tobe understood that any suitable removable connecting means may be employed.

The upper handle 1 isprovided with a slot 4 through which extends a screw'5, preferably flat, having a winged lock nut 6.v The screw 5 is anchored in a slot 8 of the lower handle 2 by means of a removable pin or screw 9. It will be observed that the s'crew'5 is bent and corresponds to the are described by the handles 1 and 2, thereby reducing the amount of clearance necessary in the slots 4 and 8. If it is desired to replace the member 5, thesame can be accomplished by removing thescrew 9, thus enabling the screw 5 to be removed from itsslot in the handles.v

A flat spring 10 is secured to the under face of handle 1 by a rivet or the like 11, and bears against the upperface of the lower handle 2. A slot 12 in the spring enables the screw 5 to extend therethrough. The tension of the spring l0'is such that the handles 1 and 2 are normally urged and maintained apart to the extent permitted by the nut. 6. The nut, therefore, affords a simple andeffective means for locking the clamping jaws in position on the bone.

The upper handle 1 is provided at its end with a pair of outwardly diverging prongs l3 and 14, the inner faces of which may be formed with serrations 15. These prongs form the lower jaw of the clamp. Formed integrally with the end of the handle 1, and extending substantially perpendicularly to the prongs 13 and 14, is a stirruplike member 16. a

The other clamp jaw, designated generally 1'7, is made up of an engaging portion 18 and a body portion '19. As shown in Figure 1, a single jaw may be employed, but, if desired, a pair of jaws 21, as shown in Figure 4, may be substituted. Under ordinary conditions I find that a single jaw is sufficient. As is the case with the lower jaws the upper jaw may be serrated to afford better frictional engagement. 1

The upper jaw is adapted to slide upon the stirrup-like member 16, in order to insure that movement of the upper and lower jaws with respect to each other is confined to a single plane, which may be considered perpendicular. This I have found to be preferable to the arcuate movement which normally occurs in a clamp of this general character. The body portion 19 is pro-, vided with a pair of upwardly extending and spaced ears 22. As best shown in Figure 3, channels 23 are cut into the ears and bodyportion 19 within which the stirrup fits. These channels serve to guide the jaw 17 upon the stirrup.

A bar 24 is integral with and extends between the two ears 22. As shown in Figure 3, the bar 24 is to the rear of the ears 22, and for this purpose the ears 22 may be provided with rearward projections 25, as shown in Figure 1.

The handle 2, forwardly from the pivot 3, is flattened, as indicated at 26 in Figures 1 and 2. A slot 27 is cut intothe end of the portion 26 and into this slot the bar 24 fits. The member 26 projects forwardly of-the bar 24, and is adapted to slide within the stirrup 16.

It will be observed that the member 2 and the jaw 1'7 may be removed from the handle 1 and lower jaws, and the device disassembled for the purpose of facilitating sterilization. The screw may be freed from the handle 2 by removing the pin or screw 9. The pivot screw 3 may then be removed, at which time the handle 22 may be freed from engagementwith the upper jaw 17. The upper jaw 17 in turn may also be removed from the stirrup 16, merely sliding it oil of the stirrup. It will be appreciated, or course, that there is no danger of the jaw 1'7 being'removed from the stirrup when the clamp is assembled because upward movement of the jaw 17 is limited by the forward end of handle 2 contacting with the top of the stirrup.

It is believed that the operation of my device is apparent from the foregoing. The surgeon first makes an incision to expose the broken bone which is to be aligned and set. After the soft tissues, such as the muscles, nerves, arteries, etc. have been retracted in the usual manner, a metal strip 28 is placed over the broken portion of the bone, if it is necessary to use one. The lower jaws 13 and 1 and the upper jaw 1'? of my clamp are then inserted into the incision over the metal and the bone, and are manipulated by the handles 1 and 2 until the broken portions of the bone are brought to perfect coaptation. The

1 look nut 6 on the fiat screw 5 is then rotated the necessary distance on the screw and the clamp is thereby locked in its adjusted position. After the transplant has been made, the lock nut is rotated away from the handle, thus unlocking the clamp and permitting the same to be removed from the bone.

The advantages of my invention will be readily appreciated. Inasmuch as the handles extend horizontally from the bone, the surgeon has no interference and is free to use a brace, or the like, in driving the screws into the metal. By using a horizontal clamp, operations of this nature can be performed in approximately one-half the time heretofore required when using the prior type of clamp. Furthermore, it will be noted that my clamp may be readily disassembled into the individual elements, thereby insuring an adequate and thorough sterilization. Furthermore, it will be appreciated that my invention may be economically manufactured, and, if necessary, the individual elements may be replaced rather than requiring a complete new clamp.

While I have shown and described the preferred embodiment of my invention, I wish it to be understood that I do not confine myself to the precise details of construction herein set forth, by way of illustration, as it is apparent that many changes and variations may be made therein by those skilled in the art, without departing from the spirit of the invention, or exceeding the scope of the appended claims.

I claim: s

1. A surgical instrument comprising upper and lower pivoted handles, a jaw permanently secured to the upper handle, a jaw secured to the lower handle and adapted to be removed therefrom, said permanently secured jaw being provided with guiding means whereby the other jaw may be moved perpendicularly to it, the jaw engaging portion of the lower handle extending through the guiding means;

2. A surgical instrument comprising upper and'lower handles pivotally connected to each other, a jaw detachably secured to the lower handle, the upper handle being provided at its end with a jaw having integral therewith a guide member adapted to limit to a single plane movement of the other jaw, the lower handle projecting through the guide and engaging a bar on the detachable jaw, a flat screw anchored in a slot in the lower handle and extending through a slot in the upper handle, a lock nut threaded on the flat screw for locking the jaws in a desired position, a flat spring fixed to the under face of the upper handle and provided with a slot for enabling the flat screw to extend therethrough, and a removable pivot for permitting disengagement of the handles.

3. A surgical instrument comprising a pair of pivoted handles, a jaw formed integral with one of said handles, a yoked member extending from the inner end of said jaw and substantially perpendicular thereto, another jaw slidable on the outside of the yoked member and engageable by the other handle.

4. A bone clamp comprising a pair of pivoted handles, a jaw integral with and extending from one end of one of said handles, a U-shaped extension at the point of junction of said handle and said jaw and substantially perpendicular to the jaw, another jaw adapted to cooperate with thefirst mentioned jaw to move to and from said jaw in substantially a single plane, said second jaw provided with channels adaptedto receive the exterior of the U-shaped member and to slide thereon, means on said second mentioned jaw adapted to be engaged by the other handle, and means for locking the jaws in a desired position.

5. A bone clamp comprising a pair of pivoted handles, a jaw integral with and extending from one of said handles, the other handle being provided with a slot at one end, an inverted U-shaped extension at the point of junction of said handle and said jaw, and substantially perpendicular to the jaw, another jaw adapted to cooperate with the first jaw to clamp the bone, said second jaw being provided witha. body portion and upwardly extending arms, channels upon the interior of the arms and extending through the body portion, said channels adapted to receive the U- shaped member to guide the clamp thereon, and a bar extending between the arms and adapted to receive the slot in the other handle.

HENRY P. RUSH. 

